Xu Shan, Frakulli Rezarta, Lin Yilan
Department of Ophthalmology, University Hospital Essen, 45147 Essen, Germany.
Department of Oncology, Mianyang Central Hospital, Mianyang 621000, China.
Cancers (Basel). 2023 Dec 3;15(23):5698. doi: 10.3390/cancers15235698.
This study aimed to assess the relative efficacy of modern radiotherapy strategies in patients with newly diagnosed glioblastoma.
A comprehensive literature review was conducted through MEDLINE, Embase and the Cochrane Central Registry of Controlled Trials of studies focused on newly diagnosed glioblastoma published up to and counting 15 September 2022. We included randomized controlled trials (RCTs) and comparative nonrandomized studies (NRSs) of radiotherapy for newly diagnosed glioblastoma. Eligible studies included patients treated with three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, volumetric modulated arc therapy or proton therapy reporting either overall survival, progression-free survival or both. The impact of different radiotherapy modalities on survival was evaluated by direct comparisons of indirect evidence and estimated hazard ratios in terms of a Bayesian network meta-analysis.
A total of six RCTs or NRSs comprising 816 glioblastoma patients with modern radiotherapy strategies were reviewed, yielding improved overall survival by proton therapy over all other regimens. The network meta-analysis also indicated a significant advantage of proton therapy compared with other radiotherapy strategies in regard to progression-free survival.
Our findings suggested PT as a standard RT regime with possibly superior survival outcomes for selected patients with GBM.
本研究旨在评估现代放疗策略对新诊断胶质母细胞瘤患者的相对疗效。
通过MEDLINE、Embase和Cochrane对照试验中央注册库，对截至2022年9月15日发表的聚焦于新诊断胶质母细胞瘤的研究进行了全面的文献综述。我们纳入了新诊断胶质母细胞瘤放疗的随机对照试验（RCT）和比较性非随机研究（NRS）。符合条件的研究包括接受三维适形放疗、调强放疗、容积调强弧形放疗或质子治疗的患者，报告了总生存期、无进展生存期或两者。通过间接证据的直接比较和贝叶斯网络荟萃分析中的估计风险比，评估了不同放疗方式对生存的影响。
共回顾了6项RCT或NRS，包括816例采用现代放疗策略的胶质母细胞瘤患者，结果显示质子治疗比所有其他方案的总生存期更长。网络荟萃分析还表明，与其他放疗策略相比，质子治疗在无进展生存期方面具有显著优势。
我们的研究结果表明，质子治疗作为一种标准的放疗方案，可能对部分胶质母细胞瘤患者具有更好的生存结局。
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